Characterization and physiological effect of tapioca maltodextrin colloid plasma expander in hemorrhagic shock and resuscitation model

Abstract

Plasma expanders (PEs) are administered fluids to replace blood volume when massive blood loss has occured. Maltodextrin from tapioca starch was selected as a study candidate to prepare a colloid PE due to an uncomplicated production process. The formulations of mixture between tapioca maltodextrin and 0.9 % sodium chloride solution were prepared and then characterized. This was to investigate the effects of a dextrose equivalent (DE) and the concentration on the physical properties. Storage stability of each formulation was also determined and compared with clinically used PE [6 % hydroxyethyl starch (HES), 130/0.4]. The effects on the circulatory system in hamsters with hemorrhagic shock and resuscitation using prepared PE were also investigated. The results showed that low DE value led to high retrogradation, turbidity and viscosity but low colloid osmotic pressure and poor solubility. Among the prepared solutions, tapioca maltodextrin with DE6 at 10 % w/v concentration had comparable properties with 6 % HES 130/0.4. Animals resuscitated with 10 % DE6 PE had improved mean arterial blood pressure similar to those resuscitated with 6 % HES 130/0.4. However, several parameters in animals resuscitated with 10 % DE6 PE were lower than those resuscitated with 6 % HES 130/0.4, i.e., heart rate, functional capillary density. Therefore, if using tapioca maltodextrin for PE, some properties have to be considered and efficiently optimized.

Physical and Rheological Characteristics of Hydroxypropyl, Acid‐Thinned Tapioca Starch‐Based Plasma Expander for Blood Volume Replacement

“…The viscosities of HPS‐based PEs stored for 4 weeks were quite similar to Day 1 when stored either at 25 ± 2 °C or at 4 ± 2 °C. This viscosity stability is possibly due to the low retrogradation of hydroxypropyl, acid thinned tapioca starch, which is different from the results of PEs prepared from native tapioca starch and low DE tapioca maltodextrin …”

“…Additionally, an increasing concentration of HPS increased COP in a nonlinear fashion as an exponential function. In our previous study, we found that tapioca maltodextrin colloid PE had a linear relationship to the concentration . Therefore, the type of starch derivative influences COP of PE.…”

“…Higher concentrations potentially cause higher viscosity. The influence of starch concentration on the viscosity of a solution was addressed in previous researches . These studies suggested that higher concentrations of starch solutions had higher viscosities.…”

“…Medical applications for tapioca starch have not been extensively studied, but its general characteristics indicate that it could be used as raw material for PE. Several recent studies have looked at this possibility by investigating the physical and rheological properties of tapioca PE . However, modified tapioca starch using propylation, acid‐thinned technique has not to date its physical and rheological properties examined with regard to its possible use as PE.…”